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Organization
UTAH LAKES NEUROSCIENCE MENTAL HEALTH CENTER PLLC
Active
Organization
UTAH LAKES NEUROSCIENCE MENTAL HEALTH CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIANA RONEY LCSW (OWNER)
(385) 265-2484
Entity
Organization
Contact information
Practice address
3549 N UNIVERSITY AVE STE 200, PROVO, UT 84604-4417
(385) 265-2484
(877) 894-5104
Mailing address
223 W COUGAR BLVD # 704, PROVO, UT 84604-2546
(385) 265-2484
(877) 894-5104
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11486773-3501
LCSW LICENSE
UT
Enumeration date
04/01/2020
Last updated
04/02/2020
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